In the field of wound repair, scarless healing and complete reconstruction of skin function are major challenges in clinical and basic research. At present, a variety of artificial dermal scaffolds have been used in the clinical repair of wounds to overcome the problems such as skin structural disorders caused by tissue defects. The biomaterials used to make artificial dermal scaffolds in skin and tissue engineering research mainly include three categories: natural biomaterials, biosynthetic materials, and organic polymer materials. This review summarizes the biocompatibility, bioactivity, and degradability of biomaterials and their effects on wound healing, and provides an overview of artificial dermal scaffold construction strategies based on biomaterials, wound healing cells, and associated cytokines.
Biocompatible Materials/chemistry* ; Tissue Scaffolds/chemistry* ; Skin, Artificial ; Skin ; Polymers/chemistry* ; Cytokines

The accurate diagnosis of burn wound depth is particularly important for evaluating the disease prognosis of burn patients. In the past, the diagnosis of burn wound depth often relied on the subjective judgment of doctors. With the continuous development of diagnostic technology, the methods for judging the depth of burn wound have also been updated. This paper mainly summarizes the research progress in the applications of indocyanine green angiography, laser Doppler imaging, laser speckle contrast imaging, and artificial intelligence in the diagnosis of burn wound depth, and compares the advantages and disadvantages of these techniques, so as to provide ideas for accurate diagnosis of burn wound depth.
Angiography ; Artificial Intelligence ; Burns/diagnosis* ; Humans ; Laser-Doppler Flowmetry/methods* ; Skin ; Wound Healing

Objective: To investigate the characteristics and comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome. Methods: A retrospective observational study was conducted. From May 2012 to December 2021, the data of 19 patients with iatrogenic Cushing's syndrome discharged from the Department of Burns and Plastic Surgery of the First Affiliated Hospital of Guangxi Medical University were collected, including 8 males and 11 females, aged 28-71 (56±11) years, with 12 cases of infected acute wounds and 7 cases of infected chronic wounds. The lesions were located in the limbs, perianal, and sacrococcygeal regions, with original infection ranging from 9 cm×5 cm to 85 cm×45 cm. After admission, the patients were performed with multidisciplinary assisted diagnosis and treatment, and the wounds were treated with debridement and vacuum sealing drainage, according to the size, severity of infection, suture tension, and bone and tendon tissue exposure of wounds, direct suture or autologous skin and/or artificial dermis and/or autologous tissue flap transplantation was selected for wound repair. The levels of cortisol and adrenocorticotropic hormone (ACTH) of patients at 8:00, 16:00, and 24:00 within 24 h after admission were counted. After admission, the number of operations, wound repair methods, and wound and skin/flap donor site healing of patients were recorded. During follow-up, the wounds were observed for recurrent infection. Results: The cortisol levels of 16 patients at 8:00, 16:00, and 24:00 within 24 h after admission were (130±54), (80±16), and (109±39) nmol/L, respectively, and ACTH levels were (7.2±2.8), (4.1±1.8), and (6.0±3.0) pg/mL, respectively; and the other 3 patients had no such statistical results. After admission, the number of surgical operation for patients was 3.4±0.9. The following methods were used for wound repair, including direct suturing in 4 cases and autologous skin and/or artificial dermis grafting in 9 cases, of which 2 cases underwent stage Ⅱ autologous skin grafting after artificial dermis grafting in stage Ⅰ, and 6 cases had pedicled retrograde island flap+autologous skin grafting. The wound healing was observed, showing that all directly sutured wounds healed well; the wounds in 6 cases of autologous skin and/or artificial dermis grafting healed well, and the wounds in 3 cases also healed well after the secondary skin grafting; the flaps in 4 cases survived well with the wounds in 2 cases with distal perforators flap arteries circumfluence obstacle of posterior leg healed after stage Ⅱ debridement and autologous skin grafting. The healing status of skin/flap donor sites was followed showing that the donor sites of medium-thickness skin grafts in the thigh of 4 cases were well healed after transplanted with autologous split-thickness grafts from scalp; the donor sites of medium-thickness skin grafts in 3 cases did not undergo split-thickness skin grafting, of which 2 cases had poor healing but healed well after secondary skin grafting 2 weeks after surgery; the donor sites of split-thickness skin grafts in the head of 2 patients healed well; and all donor sites of flaps healed well after autologous skin grafting. During follow-up of more than half a year, 3 gout patients were hospitalized again for surgical treatment due to gout stone rupture, 4 patients were hospitalized again for surgical treatment due to infection, and no recurrent infection was found in the rest of patients. Conclusions: The infected wounds in patients with iatrogenic Cushing's syndrome have poor ability to regenerate and are prone to repeated infection. Local wound treatment together with multidisciplinary comprehensive treatment should be performed to control infection and close wounds in a timely manner, so as to maximize the benefits of patients.
Adrenocorticotropic Hormone ; China ; Cushing Syndrome/surgery* ; Female ; Gout ; Humans ; Hydrocortisone ; Iatrogenic Disease ; Male ; Skin, Artificial ; Wound Infection

Natural dermal matrix has good biocompatibility and can serve as " biological template" in wound repair. According to the source of material, natural dermal matrix can be divided into acellular dermal matrix (ADM), denatured dermal matrix, and scar dermal matrix. ADM is a biological material prepared by removing cellular components from the skin and retaining extracellular matrix (ECM) of the dermis. ADM possesses abundant natural biological information, low immunogenicity, and excellent regenerative capacity, which has greatly promoted the development of wound healing specialty as dermal substitute. Denatured dermis matrix is a layer of dermal tissue made by superficial tangential excision or dermabrasion on deeply burned wounds. The retained denatured dermis can recover gradually after transplantation of autologous skin on its surface, with similar structure, morphology, and biomechanics to healthy dermis. Scar dermal matrix is a kind of dermal scaffold made of autologous split-thickness scar tissue, possessing the characteristics of high survival rate, good texture, and slight scar reaction. Scar dermal matrix can effectively reduce secondary damage to the donor site when repairing scar contracture deformity. Based on the research progress at home and abroad and the opinions of domestic experts, this paper summarizes the indications, application methods, contraindications, and considerations of different types of natural dermal matrix in application of wound repair.
Acellular Dermis ; Burns/surgery* ; Consensus ; Humans ; Skin Transplantation ; Skin, Artificial ; Wound Healing

As a temporary skin substitute, the dressings can protect the wound, stop bleeding, prevent infection and contribute to wound healing. According to the characteristics of the materials, wound dressings can be classified into traditional wound dressings, interactive dressings, bioactive dressings, tissue engineering dressings and smart dressings, etc. Different dressings have different characteristics, and some products have been widely used in clinic. Recently nanomaterials and three-dimensional bio-printing technology have significantly improved the performance of wound dressings. Future dressings will be developed from single function to multi-function composite, and integrated into an intelligent one. This paper reviews the current research progress and future development prospects of wound dressings.
Bandages ; Skin, Artificial ; Tissue Engineering ; Wound Healing

Skin-substitute has developed rapidly and it is essential to evaluate its effectiveness before clinical use.This paper reviews the development of skin-substitute,methods to evaluate the effectiveness of skin-substitute and relevant standards.This paper highlights the and means of preclinical effectiveness evaluation and provides theoretical basis for preclinical safety evaluation of skin-substitute.
Skin, Artificial

Artificial dermis is a kind of tissue engineering dermal substitute and is used to repair dermal defects caused by a variety of reasons. This article describes the characteristics and the mechanism of repair and reconstruction of bilayer artificial dermis. Based on domestic experience of clinical applications and relative literature of bilayer artificial dermis, more than 50 domestic experts in related field reached a consensus on indications, contraindications, operation procedures in clinical application, cautions, and treatment and prevention of complications of bilayer artificial dermis, providing reference for clinical application.
Consensus ; Dermis ; pathology ; Skin Transplantation ; methods ; Skin, Artificial ; Tissue Engineering

Artificial Intelligence ; Deep Learning ; Diabetic Retinopathy ; diagnosis ; Humans ; Image Processing, Computer-Assisted ; Machine Learning ; Mass Screening ; Melanoma ; diagnosis ; Referral and Consultation ; Skin Neoplasms ; diagnosis ; Triage

BACKGROUND: Aeration of the lungs must be monitored during general anesthesia because of the possibility of postsurgical pulmonary complications. The aim of this study was to compare PaO₂/FiO₂ and the number of regions with B-line on transthoracic lung ultrasonography (TLU) between the postinduction and postsurgical periods. METHODS: Twenty-six adult patients undergoing major abdominal surgery were enrolled. Arterial blood gas analysis and TLU were performed 30 min after the induction of anesthesia (postinduction) and after skin closure (postsurgical period) while patients were under mechanical ventilation. TLU was performed in 12 regions (anterior, lateral, and posterior in the upper and lower regions of both lungs). The number of regions with B-line was counted. RESULTS: Compared with postinduction values, the number of regions with B-line on TLU was increased in the postsurgical period (0.3 ± 0.5 to 1.3 ± 1.2, P < 0.001); however, PaO₂/FiO₂ did not significantly differ (421.3 ± 95.8 to 425.2 ± 86.0, P = 0.765). The change in PaO₂/FiO₂ (postinduction-postsurgical period) was significantly higher in Group B than in Group A (P = 0.028). CONCLUSIONS: Although the number of regions with B-line on TLU was increased in the postsurgical period, lung oxygenation did not differ, based on the main assessment in this study. In contrast, patients with an increased number of regions with B-line tended to show a reduction in PaO₂/FiO₂ during the postsurgical period. Further study seems necessary to establish the number of regions with B-line on TLU as a tool for evaluation of perioperative oxygenation.
Adult ; Anesthesia ; Anesthesia, General ; Anesthesiology ; Blood Gas Analysis ; Humans ; Lung ; Observational Study ; Oxygen ; Prospective Studies ; Pulmonary Atelectasis ; Pulmonary Ventilation ; Respiration, Artificial ; Skin ; Ultrasonography

A 72-year-old man underwent spinal anesthesia for artificial urinary sphincter placement for urinary incontinence. After the block level was confirmed below T6, 1 g of cefotetan, which had not shown any reaction on skin test, was administered as a prophylactic antibiotic. The patient began complaining of chest discomfort and dyspnea shortly after injection. ST elevation appeared on the electrocardiogram and the patient's pulse could not be palpated. Accordingly, cardiopulmonary resuscitation was performed for 5 minutes; the patient recovered spontaneous circulation. The patient was diagnosed as experienced coronary artery spasm by coronary angiography with spasm test. Because coronary artery spasm can also develop in patients with no history of coronary artery disease and under spinal anesthesia, careful observation, suspicion of coronary artery spasm and prompt response to hemodynamic and electrocardiogram changes are necessary.
Aged ; Anesthesia, Conduction ; Anesthesia, Spinal* ; Cardiopulmonary Resuscitation ; Cefotetan ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm ; Coronary Vessels* ; Dyspnea ; Electrocardiography ; Heart Arrest* ; Hemodynamics ; Humans ; Skin Tests ; Spasm* ; Thorax ; Urinary Incontinence ; Urinary Sphincter, Artificial